NPIMap

Organization Active NPI

Bon Secours Memorial Regional Medical Center Inc

  • Neurology Physician
  • Mechanicsville, VA
National Provider Identifier
1306193347
Registry record updated Jul 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
BON SECOURS MEMORIAL REGIONAL MEDICAL CENTER INC
Practice address
8266 Atlee Rd Ste 330
Mechanicsville, VA 23116-1812
Phone
(804) 325-8720
Fax
(804) 764-7351
NPI assigned
Aug 9, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Stephan Quiriconi
Title
Cfo
Phone
(804) 281-8301

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

8266 Atlee Rd Ste 330
Mechanicsville, VA 23116-1812

Mailing address

8580 Magellan Pkwy
Richmond, VA 23227-1149
Phone (804) 627-5462

Other identifiers 1

IdentifierTypeStateIssuer
C06115OtherVAGROUP PTAN

Other names 1

  • Bon Secours Neurology Clinic at Memorial Regional Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040726000687 VA Part B Supplier - Clinic/Group Practice 6507775293 Receives reassigned benefits from 75 practitioners
26 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Kilmarnock, VA; Glen Allen, VA; Richmond, VA; Mechanicsville, VA; King William, VA

Other NPIs on the same Medicare enrollment 23

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 23

National Provider Directory

National Provider Directory

Locations

11601 Iron Bridge Rd
Ste 207
Chester, VA 23831
Phone (804) 285-6880

8262 Atlee Rd
Ste 330
Mechanicsville, VA 23116
Phone (804) 325-8720

8262 Atlee Rd
Ste 201
Mechanicsville, VA 23116
Phone (804) 325-8720

601 Watkins Centre Pkwy
Midlothian, VA 23114
Phone (804) 594-2100

1500 N 28th St
Ste 204
Richmond, VA 23223

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1344470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562803200000",
    "number": "1306193347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8580 MAGELLAN PKWY",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232271149",
            "telephone_number": "804-627-5462",
            "fax_number": "866-449-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8266 ATLEE RD STE 330",
            "city": "MECHANICSVILLE",
            "state": "VA",
            "postal_code": "231161812",
            "telephone_number": "804-325-8720",
            "fax_number": "804-764-7351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BON SECOURS MEMORIAL REGIONAL MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-09",
        "last_updated": "2019-07-11",
        "status": "A",
        "authorized_official_last_name": "QUIRICONI",
        "authorized_official_first_name": "STEPHAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "804-281-8301"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C06115",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bon Secours Neurology Clinic at Memorial Regional",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bon Secours Neurology Clinic at Memorial Regional",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mechanicsville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.